HCC risk prediction using biomarkers in non-cirrhotic patients following HCV eradication: Reassuring the patient or the doctor?
| Autor: | Charlotte E. Costentin, P. Nahon |
|---|---|
| Přispěvatelé: | Hypoxie : Physiopathologie Respiratoire et Cardiovasculaire (HP2), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Grenoble Alpes (UGA), Institute for Advanced Biosciences / Institut pour l'Avancée des Biosciences (Grenoble) (IAB), Centre Hospitalier Universitaire [Grenoble] (CHU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Etablissement français du sang - Auvergne-Rhône-Alpes (EFS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA), Centre Hospitalier Universitaire [Grenoble] (CHU), Centre de Recherche des Cordeliers (CRC (UMR_S_1138 / U1138)), École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université de Paris (UP), Hôpital Avicenne [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Unité de Formation et de Recherche Santé, Médecine, Biologie Humaine [Bobigny], Université Paris 13 (UP13)-Sorbonne Paris Cité, Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPCité), HAL-SU, Gestionnaire |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Oncology
EASL European Association for the Study of the Liver MESH: Adenine Nucleotides MESH: Solvents RC799-869 MESH: Myxomycetes risk prediction 0302 clinical medicine [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases Immunology and Allergy Liver Cancer Risk FIB4 Fibrosis-4 ComputingMilieux_MISCELLANEOUS MESH: Cyclic AMP AUROC area under the receiver operating curve AFP alpha-fetoprotein DAA direct-acting antivirals STARD Standards for the Reporting of Diagnostic Accuracy Studies Gastroenterology LCR1-LCR2 circulating biomarkers Diseases of the digestive system. Gastroenterology 3. Good health NPV negative predictive value Cirrhosis 030220 oncology & carcinogenesis [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases surveillance 030211 gastroenterology & hepatology VCTE vibration-controlled transient elastography Liver cancer Multi-analyte blood test Research Article medicine.medical_specialty SIR standardised incidence ratio MESH: Biological Products AFP FibroTest™ [SDV.CAN]Life Sciences [q-bio]/Cancer MESH: Chromatography 03 medical and health sciences NNS needed to screen [SDV.CAN] Life Sciences [q-bio]/Cancer Internal medicine Internal Medicine medicine SVR sustained virological response Hepatology Fibrosis progression business.industry CHC chronic HCV [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology medicine.disease [SDV.MHEP.HEG] Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology digestive system diseases Circulating biomarkers [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie STROBE Strengthening the Reporting of Observational Studies in Epidemiology [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie business HCC hepatocellular carcinoma LCR Liver Cancer Risk |
| Zdroj: | JHEP Reports Innovation in Hepatology JHEP Reports Innovation in Hepatology, Elsevier, 2021, 3 (4), pp.100320. ⟨10.1016/j.jhepr.2021.100320⟩ JHEP Reports JHEP Reports Innovation in Hepatology, 2021, 3 (4), pp.100320. ⟨10.1016/j.jhepr.2021.100320⟩ JHEP Reports, Vol 3, Iss 4, Pp 100320-(2021) |
| ISSN: | 2589-5559 |
| DOI: | 10.1016/j.jhepr.2021.100320⟩ |
| Popis: | Background & Aims The Liver Cancer Risk test algorithm (LCR1-LCR2) is a multianalyte blood test combining proteins involved in liver cell repair (apolipoprotein-A1 and haptoglobin), known hepatocellular carcinoma (HCC) risk factors (sex, age, and gamma-glutamyl transferase), a marker of fibrosis (alpha2-macroglobulin) and alpha-fetoprotein (AFP), a specific marker of HCC. The aim was to externally validate the LCR1-LCR2 in patients with chronic HCV (CHC) treated or not with antivirals. Methods Pre-included patients were from the Hepather cohort, a multicentre prospective study in adult patients with CHC in France. LCR1-LCR2 was assessed retrospectively in patients with the test components and AFP, available at baseline. The co-primary study outcome was the negative predictive value (NPV) of LCR1-LCR2 for the occurrence of HCC at 5 years and for survival without HCC according to the predetermined LCR1-LCR2 cut-offs. The cut-offs were adjusted for risk covariables and for the response to HCV treatment, and were quantified using time-dependent proportional hazards models. Results In total, 4,903 patients, 1,026 (21.9%) with baseline cirrhosis, were included in the study. Patients were followed for a median of 5.7 (IQR 4.2–11.3) years. A total of 3,788/4,903 (77.3%) patients had a sustained virological response. There were 137 cases of HCC at 5 years and 214 at the end of follow-up. HCC occurred at 5 years in 24/3,755 patients with low-risk LCR1-LCR2 compared with 113/1,148 patients with high-risk LCR1-LCR2. The NPV was 99.4% (95% CI 99.1–99.6). Similar findings (hazard ratio, 10.8; 95% CI, 8.1–14.3; p Graphical abstract Highlights • HCC is the fourth leading cause of cancer-related death worldwide and the fastest growing cause of cancer deaths in the USA. • The American Association for the Study of Liver Diseases recommends surveillance every 6 months only in patients with cirrhosis. • The LCR1-LCR2 algorithm is a multianalyte blood test combining proteins involved in cell repair, fibrosis and liver cancer. • The LCR1-LCR2 algorithm was able to identify patients with chronic HCV at very low risk of HCC at 5 years. • This algorithm could help clinicians to reassure a percentage of patients with chronic HCV that their risk of developing HCC remains low. |
| Databáze: | OpenAIRE |
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